Performing CT scans in the emergency department (ED) for patients experiencing dizziness may not be worth the expense, according to a study conducted at Henry Ford Hospital in Detroit and presented Jan. 26 at the Triological Society Combined Sections Meeting in Miami.
“When a patient comes into the emergency department experiencing dizziness, a physician’s first line of defense is often to order a CT scan to rule out more serious medical conditions. But in our experience it is extremely rare that brain and head imaging yields significant results,” Syed F. Ahsan, MD, of the department of otolaryngology-head & neck surgery at Henry Ford, said in a statement.
Ahsan and colleagues conducted a retrospective chart review of 1,681 patients who presented to metropolitan emergency rooms with dizziness and vertigo between January 2008 and January 2011.
A total of 810 patients underwent CT imaging at a cumulative cost of $988,200. According to the study abstract, only 0.74 percent of those scans yielded clinically significant results that required intervention, such as intracranial bleeding or stroke.
The analysis also revealed that older patients and those with a lower income were more likely to receive a CT scan for dizziness when they came into the emergency department.
The study demonstrated that there is potential for cost savings by creating and implementing stronger guidelines to determine when it is medically necessary for patients with dizziness to undergo CT imaging in the emergency department.
“It is our hope that our investigation into our own practices will shed light on avenues to run leaner practices within our institution, as well as serve as a model for other health systems,” said Ahsan.